National surveillance of dialysis associated diseases in the United States, 1995.
Chronic hemodialysis centers in the United States were surveyed in 1995 regarding a number of hemodialysis associated diseases and practices. A total of 2,647 centers, representing 224,954 patients and 54,194 staff members, responded. Seventy-seven percent of centers reported that they reused disposable dialyzers. At the end of 1995, 65% of patients were treated with an arteriovenous graft, 22% an arteriovenous fistula, and 13% a temporary or permanent central catheter. By the end of 1995, at least three doses of hepatitis B vaccine had been administered to 35% of patients and to 82% of staff members. Acute infection with the hepatitis B virus (HBV) occurred in 0.06% of patients, and was more likely to be reported by centers with lower proportions of patients vaccinated against HBV. The prevalence of antibody to hepatitis C virus (HCV) was 10.4% among patients and 2.0% among staff. At least one patient with vancomycin resistant enterococci (VRE) was reported by 11.5% of centers, more commonly by hospital (vs freestanding centers not located in hospitals) and government centers, and centers located in certain geographic areas. Vancomycin was received by 7.2% of patients in December 1995. The percentage of centers reporting patients with other pathogens was 7.9% for active tuberculosis, 39% for human immunodeficiency virus (HIV), and 40% for methicillin resistant Staphylococcus aureus (MRSA).
Tokars
J I
JI
Investigation and Prevention Branch, Hospital Infections Program, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Department of Health and Human Services, Atlanta, Georgia 30333, USA.
Miller
E R
ER
Alter
M J
MJ
Arduino
M J
MJ
D001166:Arteriovenous Shunt, Surgical; D002408:Catheters, Indwelling; D017743:Equipment Reuse; D015658:HIV Infections / Q000453:epidemiology / Q000209:etiology; D006509:Hepatitis B / Q000453:epidemiology / Q000209:etiology; D006526:Hepatitis C / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D015994:Incidence; D011159:Population Surveillance; D006435:Renal Dialysis / Q000009:adverse effects*; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000209:etiology; D011795:Surveys and Questionnaires; D014376:Tuberculosis / Q000453:epidemiology / Q000209:etiology; D014481:United States / Q000453:epidemiology